The incompetence of this hospital should result in an immediate involuntary corrective action by the ASA(American Stroke Association)! But nothing will occur! There is NO LEADERSHIP ANYWHERE IN STROKE!
LTE: Susan Boyer on stroke recovery and care gaps
Dear Editor,
In October, my husband suffered a stroke, resulting in a 40% to 80% loss of vision, along with other stroke deficits. The diagnosis was confirmed through emergency department and neurology consultation at a major, credentialed stroke center.
What followed was not coordinated stroke recovery, but prolonged and consequential gaps in care.
Stroke follow-up was scheduled five months after the event. In the interim, there was no plan for cognitive assessment, rehabilitation, or occupational or physical therapy. There was no physiatry consultation and no evaluation of the extent or functional impact of his vision loss. A referral to neuro-ophthalmology resulted in visual field testing scheduled nearly 10 months after the stroke.
An occipital stroke with significant visual field deficit was diagnosed, yet no rehabilitation services or compensatory training were offered. Meanwhile, I observed persistent post-stroke symptoms: confusion, disorientation, memory impairment, hallucinations, balance and gait changes, and impaired visual-spatial processing. These deficits were never formally evaluated or addressed. We were given no explanation, no plan, and no guidance on how to manage or recover from stroke-related impairments.
My message to the public is simple: If you or a loved one is discharged from the emergency department after a stroke, ask whether timely follow-up, rehabilitation, and specialty care are actually available. Ask about expected timelines, and whether they meet national standards of care. Patients and caregivers deserve transparency. If timely post-stroke assessment and rehabilitation are not available, health care systems must state this clearly and early so patients can seek appropriate care elsewhere.
My message to health care systems is equally direct: Delayed stroke care is not an inconvenience. It is a patient-safety failure. Lives, independence, and futures are lost in these gaps.
When I speak of care gaps, I am naming a critical – and uncomfortable – reality: capacity without transparency. If a system cannot provide guideline-concordant post-stroke care, it has an obligation to disclose that limitation explicitly, rather than allowing patients and clinicians to assume that appropriate care is available when it is not.
Stroke recovery is time-sensitive. Delay causes harm. Silence about that reality is not neutral – it is damaging.
With concern,
Susan Boyer, DNP, RN, FAAN
Health care Advocate and Caregiver
Weathersfield, Vt.
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